慢性乙型肝炎中纤维化相关因素与瞬时弹性成像测量肝脏硬度之间的多种相关性。
Diverse correlations between fibrosis-related factors and liver stiffness measurement by transient elastography in chronic hepatitis B.
作者信息
Lin Ziyu, Liang Jing, Zhu Jianyun, Hu Chaoxia, Gu Yurong, Lai Jing, Zheng Yubao, Gao Zhiliang
出版信息
Eur J Gastroenterol Hepatol. 2018 Feb;30(2):217-225. doi: 10.1097/MEG.0000000000001023.
BACKGROUND
Several fibrosis-related factors influence liver stiffness measurements (LSM); however, these changes have not been investigated in the context of the various disease stages of chronic hepatitis B (CHB).
AIM
The aim of this study was to assess the correlations between fibrosis-related factors and LSM in different disease stages of CHB.
PATIENTS AND METHODS
Patients with mild CHB (n=305) and cirrhotic hepatitis B (cirrhotic HB) (n=137) were compared with determine the relationship between LSM and fibrosis-related factors including parameters of liver inflammation [aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (Tbil)], albumin, globulin, peripheral blood cells (neutrophil granulocytes, red blood cells, platelets), abdominal ultrasound B-scan parameters including right liver thickness, portal vein inradium, diameter of spleen (DS), thickness of spleen (TS), and splenic vein inradium (SV).
RESULTS
In patients with mild CHB, LSM was correlated strongly with ALT (r=0.3534, P<0.0001), AST (r=0.3976, P<0.0001), and ALT+AST (r=0.3760, P<0.0001). LSM was correlated closely with Tbil (r=0.2237, P<0.0001), albumin (r=-0.3126, P<0.0001), albumin/globulin (r=-0.3086, P<0.0001), SV (r=0.3317, P<0.0001), DS (r=0.4157, P<0.0001), and spleen volume (DS×TS) (r=-0.4399, P<0.0001). Red blood cells were correlated negatively with LSM in both mild CHB and cirrhotic HB patients (r=-0.1981, P=0.0203; r=-0.1593, P=0.0053). LSM was not correlated with age, peripheral blood cell parameters, right liver thickness, portal vein inradium, or TS in mild CHB or cirrhosis HB patients. However, in patients with cirrhotic HB, LSM values were not correlated significantly with other fibrosis-related factors, except for Tbil (r=0.2272, P=0.0076).
CONCLUSION
Our findings suggest that the magnitude of these correlations differs significantly between mild CHB and cirrhotic HB patients.
背景
几种与纤维化相关的因素会影响肝脏硬度测量值（LSM）；然而，尚未在慢性乙型肝炎（CHB）的不同疾病阶段的背景下研究这些变化。
目的
本研究的目的是评估CHB不同疾病阶段纤维化相关因素与LSM之间的相关性。
患者与方法
比较轻度CHB患者（n = 305）和乙型肝炎肝硬化（肝硬化HB）患者（n = 137），以确定LSM与纤维化相关因素之间的关系，这些因素包括肝脏炎症参数[氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（Tbil）]、白蛋白、球蛋白、外周血细胞（中性粒细胞、红细胞、血小板）、腹部超声B超参数，包括肝右叶厚度、门静脉内径、脾直径（DS）、脾厚度（TS）和脾静脉内径（SV）。
结果
在轻度CHB患者中，LSM与ALT（r = 0.3534，P < 0.0001）、AST（r = 0.3976，P < 0.0001）以及ALT + AST（r = 0.3760，P < 0.0001）密切相关。LSM与Tbil（r = 0.2237，P < 0.0001）、白蛋白（r = -0.3126，P < 0.0001）、白蛋白/球蛋白（r = -0.3086，P < 0.0001）、SV（r = 0.3317，P < 0.0001）、DS（r = 0.4157，P < 0.0001）以及脾体积（DS×TS）（r = -0.4399，P < 0.0001）密切相关。在轻度CHB和肝硬化HB患者中，红细胞均与LSM呈负相关（r = -0.1981，P = 0.0203；r = -0.1593，P = 0.0053）。在轻度CHB或肝硬化HB患者中，LSM与年龄、外周血细胞参数、肝右叶厚度、门静脉内径或TS均无相关性。然而，在肝硬化HB患者中，除Tbil外，LSM值与其他纤维化相关因素无显著相关性（r = 0.2272，P = 0.0076）。
结论
我们的研究结果表明，轻度CHB和肝硬化HB患者之间这些相关性的程度存在显著差异。
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